1. Sampling circulating tumor cells for clinical benefits: how frequent?
- Author
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Doreen Chek Yee Tan, Saabry Osmany, Evelyn Sc Koay, Karen Ml L. Tan, Steven Tucker, Mo-Huang Li, Delly Fareda, Hui Wen Chua, and Sai Mun Leong
- Subjects
Cancer Research ,medicine.medical_specialty ,Review ,Bioinformatics ,Circulating tumor cell ,Neoplasms ,Internal medicine ,Biomarkers, Tumor ,Humans ,Medicine ,Molecular Biology ,Cancer ,Hematology ,business.industry ,Circulating tumor cells ,Therapeutic monitoring ,Sampling interval ,Neoplastic Cells, Circulating ,medicine.disease ,Clinical trial ,Monitoring frequency ,Oncology ,Potential biomarkers ,Cancer management ,Research studies ,Clinical case ,business - Abstract
Circulating tumor cells (CTCs) are cells shed from tumors or metastatic sites and are a potential biomarker for cancer diagnosis, management, and prognostication. The majority of current studies use single or infrequent CTC sampling points. This strategy assumes that changes in CTC number, as well as phenotypic and molecular characteristics, are gradual with time. In reality, little is known today about the actual kinetics of CTC dissemination and phenotypic and molecular changes in the blood of cancer patients. Herein, we show, using clinical case studies and hypothetical simulation models, how sub-optimal CTC sampling may result in misleading observations with clinical consequences, by missing out on significant CTC spikes that occur in between sampling times. Initial studies using highly frequent CTC sampling are necessary to understand the dynamics of CTC dissemination and phenotypic and molecular changes in the blood of cancer patients. Such an improved understanding will enable an optimal, study-specific sampling frequency to be assigned to individual research studies and clinical trials and better inform practical clinical decisions on cancer management strategies for patient benefits.
- Published
- 2015